and health-related behaviors; (4) occupational and employment histories; (5) activities and attitudes; (6) residential history; (7) economic and financial well-being; and (8) emotional and instrumental support (Weinstein and Willis, 2001). Since 1989, follow-up interviews have been conducted in 1993, 1996, 1999, and 2003. In both 1996 and 2003, the study drew a refresher sample to provide a sample of persons age 50 and older.
The initial impetus for the biomarker arm of the Taiwan study of the elderly grew out of a seminar on the cumulative effects of stress on health that was presented by Burton Singer at the Office of Population Research at Princeton University in 1995. The focus of his presentation was the MacArthur Study of Successful Aging—a study of predominantly high-functioning individuals drawn from community-based cohorts that were part of the Established Populations for Epidemiological Studies of the Elderly. The longitudinal study of the elderly in Taiwan seemed to offer an opportunity to do a population-representative study—albeit of persons middle-aged and older—that incorporated biomarkers. The study had been going on for some years, there was a strong base of sociodemographic data, the institute in Taiwan had a competent staff and substantial experience fielding surveys, we had a long and productive history of cooperative work with each other, and we knew that the study sample was cooperative and responsive.
We have already presented a (simplified) diagram of our basic theoretical model in the predecessor to this volume, Cells and Surveys: Should Biological Measures Be Included in Social Science Research? (Weinstein and Willis, 2001, p. 259). Underlying the study was our interest in exploring the (often) reciprocal relationships linking the social environment with stressful experience and with health outcomes, and in elaborating the physiological responses that lie between those links and between stressful experience and health outcomes. There are huge—and growing—literatures linking the social environment with exposure to challenge, linking the social environment with health outcomes, and some linking exposure to challenge with health outcomes. What we hoped to add to the discussion (primarily) were better data on the physiological pathways that lie between the environment and health outcomes and the physiological effects of exposure to challenge. Our original approach to incorporating physiological dysregulation was based on the concept of allostatic load. The idea behind allostatic load is that stressful experience causes a chain of physiological changes that interrupt normal processes; repeated or prolonged exposure to such stressors can result in physiological dysregulation (McEwen, 2002; McEwen and Stellar, 1993). Proponents of the framework would argue that allostatic load can be viewed as an index of the relative degree of failure at a physiological level—a marker of the cumulative physiological costs of efforts to cope with life’s challenges.